Doctor Name: | STACEY LEARY |
NPI Number: | 1003224221 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RD, CDN, CNSC |
License Number: | 000933 |
Business Practice Address: | 130 Division St Derby, CT - 064181326 |
Business Phone Number: | 2037327585 |
Business Fax Number: | |
Mailing Address: | 88 Washington Ave, SEYMOUR |
State: | CT |
Postal Code: | 064833127 |
Phone Number: | 2032315544 |
Fax Number: | |
NPI Enumeration Date: | 07/31/2014 |
NPI Last Update Date: | 08/01/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | 000933 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
Taxonomy Type: | Dietary & Nutritional Service Providers |
Taxonomy Classification: | Dietitian, Registered |
Taxonomy Specialization: | |
Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |